Osseographic score (OSS) is a skeletal biomarker of biological aging, based on assessment of the hand's radiographic features. The aims of the present cross-sectional and follow-up study were: 1) to evaluate age-related changes of OSS in a large Chuvashian cohort, and 2) to evaluate sex differences in age-related changes of OSS. This study reports on intersexual differences in the pattern of skeletal aging. The most prominent difference was in the rate of skeletal change, measured as average OSS difference per year. However, no differences were found in the age at which the first skeletal change occurred. The mean values of OSS were higher in males than in females in decades 3-5 of life, but afterwards they reversed. In a follow-up study, we found that sex differences regarding the rate of OSS change began in the fifth decade, but became statistically significant only in the sixth and seventh decades. Thereafter, the rate of OSS change again became virtually equal between sexes.